Eligible Hospitals

The following hospitals are considered Eligible Hospitals (EHs) for the Medicaid EHR Incentive Program:

  • Acute Care Hospitals, including Cancer and Critical Access Hospitals (CAH), where:
    -  Average Length of Stay (ALOS) is 25 days or less; and
    -  Last four digits of the CMS Certification Number (CCN) falls within 0001-0878 or 1300-1399.
  • Children’s Hospitals, where:
    -  Last four digits of the CCN falls within 3300-3399.

Medicaid Patient Volume

To participate, Eligible Hospitals must meet a 10% Medicaid Patient Volume Threshold over a 90 Day Reporting Period. Children's Hospitals are exempt from this threshold requirement. 

 Medicaid Patient Volume

=

Number of Medicaid Patient Encounters during a 90 Day Reporting Period.

 Medicaid Patient Encounter​

=

One service per day, where Medicaid (FFS) or Medicaid 1115 Waiver (MCO) paid for all or part of the services.

 90 Day Reporting Period 

=

90 day consecutive period during the prior federal fiscal year, which runs from Oct to Sep. EHs can choose the 90 day period they want to use to attest.

CMS requires that Children’s Health Insurance Program (CHIP) patients are excluded from the Medicaid Patient Volume. A CHIP reduction factor must be applied to an EH's in-state Medicaid Patient Volume to fill this requirement. This CHIP factor varies quarterly or annually.

Eligible Hospital Incentive Calculation

The total incentive for an EH is determined based on hospital cost report data for four federal fiscal years. This can lead to millions of dollars of incentives. Read the Hospital FAQ fact sheet for the equations and an example. Use the MA Hospital Medicaid EHR Incentive Estimator (opens as MS Excel file) to determine your hospital's potential incentives.

Note: In Feb 2013, the IRS determined that the EHR incentive payments are taxable income.

Eligible Hospital Incentive Payments

Eligible Hospitals can participate for 3 years, provided they continue to meet the 10% Medicaid  Patient Volume Threshold requirement. Massachusetts will distribute their incentive in three annual payments. 

Application Year

Incentive Payment

1

50% of incentive

2

30% of incentive

3

20% of incentive

Medicare and Medicaid EHR Incentive Programs Dual Eligibility

All Eligible Hospitals, except Children's Hospitals, are eligible to receive incentive payments from both the Medicare and Medicaid EHR Incentive Programs in the same year. This is referred to as dually-eligible. If approved as a meaningful user of CEHRT by Medicare, an EH is automatically “deemed” a meaningful user by Medicaid. An EH should select “Both Medicare and Medicaid” during registration to maintain this option. EHs that register for only one program cannot change their registration after a payment is initiated, which may cause significant delays in future incentive payments.

Get Started Today!

If you have questions, please contact the MeHI Services Center via phone, Monday - Friday between the hours of 9:00 am and 4:30 pm, or via email any time. Information can also be found on the MassHealth website.

   1-855-MassEHR           MassEHR@masstech.org